Expansion of in vitro coverage fails in Senate vote

A bill to expand health insurance mandates for in vitro fertilization came to a tie vote on the Senate floor Monday night, leaving the measure’s fate uncertain.

Lawmakers debated whether the bill would overextend the state’s insurance mandates, which some blame for high health costs in Maryland.

Sen. Andy Harris, R-Baltimore and Harford, questioned the purpose of the bill, which would extend coverage to in vitro fertilization in the case of a specific combination of two fertility complications. He said it would affect only one or two couples in the state. In vitro fertilization is already mandated for insurance coverage in many cases in Maryland.

Such policy could be a slippery slope for future legislation, leading to a flood of bills tailor-made for individual constituents, Harris said.

“It’s not even a red-haired eskimo,” He said. “This is like a bald red-haired eskimo over a certain age. This is really such an unusual juxtaposition.”

A bill fails without a majority of support, which means a tie would kill the measure. But Sen. George Della, D-Baltimore City, said he plans to make a motion to reconsider the legislation.

Sen. Jim Brochin, D-Baltimore County, also opposed the bill on the grounds that this would overstep the bounds of the purpose of mandated benefits and raise insurance rates.

“Mandates are great, and they’re important, especially when it comes to preventive medicine, but our health insurance rates are off the charts,” Brochin said. “There’s going to be a time in this state, where, when we look at mandates, we’re going to draw the line at the word ‘medically necessary.’ In vitro is very important, but it’s not medically necessary.”

Senate President Mike Miller did not vote on the legislation, because he said he had not looked at the bill before Monday.

“It’s one of those things where it’s the first time it came up, it’s the first time I’ve heard about it,” Miller said. “And my personal belief is that, if somebody’s going to receive sperm from somebody else, then they can pay.”

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Health care interests representing hospitals, providers and insurers continue to spend the most to influence Maryland legislators and state officials, paying out $4.5 million to lobby this past session, according to figures compiled by Common Cause from State Ethics Commission filings.

The result is not a surprise given the state’s heavy role in both regulating and paying for health care, which makes up over $12 billion (31%) of the total state budget, including federal funds.